MORE than 240,000 people across Greater Manchester could be left without an NHS dentist under government contracts which come into force at midnight tonight.

Latest figures show that 152 out of 556 dentists have not signed up to the new system, despite the deadline.

From tomorrow, those who have not returned their contract will not officially work for the NHS under the new regime, although they will have a grace period of three months to continue health service work.

After July 1 they will not be able to do NHS work at all if they do not sign up today.

It could mean 152 fewer NHS dentists will be available in Greater Manchester. Health bosses believe the figure will be more like 44 fewer dentists in the area as they say some contracts are still under negotiation and could be signed at the last minute.

The agreement, the most significant shake-up in more than a decade, is supposed to take dentists off the "treadmill" by guaranteeing them a set salary to run their practices, rather than basing their income on the number of people they see.

The government hoped it would encourage more dentists to stay in the NHS but that does not appear to have happened.

British Dental Association representative Dr John Latham, who runs a practice in Didsbury, said his members were not impressed.

He said: "I would not sign that piece of paper if it was the last on earth.

"A lot of dentists are frightened to death of the unknown that it represents." Blackley MP Graham Stringer said: "Any contract which takes dentists away from the NHS is wrongheaded".

The worst affected area in Greater Manchester is Trafford, where 43 out of 67 dentists had not signed by Wednesday.

SERVICES: The number of NHS dentists in Greater Manchester before and after new contracts.

'Confusing'

In Heywood and Middleton eight NHS practices are disputing the agreement and two are certain not to sign, which could deprive 80,000 to 90,000 people of a dentist.

A report to health chiefs last Wednesday written by consultant in dental public health Dr Jackie Duxbury said: "From a patient perspective this will be even more confusing and could potentially replicate the situation in Scarborough a few months ago, where patients were queuing not because they needed treatment, but because they wished to be registered in order to be assured of treatment should they need it."

The report to the meeting of Central Manchester Primary Care Trust said government targets will be missed.

The average dentist has 1,600 registered patients, so if no additional dentists sign contracts 243,400 patients could be left without an NHS dentist.

Some dentists have struggled to agree contracts because salaries are based on the previous year's income. If during the previous year a dentist has been on maternity leave or worked part time, it has in some cases proved difficult to agree a full-time salary.

A Strategic Health Authority spokesman said:"We think about seven per cent of dentists will not sign but most of those are practically private anyway."